Fighting the Coronavirus Pandemic, East Asian Responses - Taiwan: Swift, Meticulous and Digital

Taiwan’s policy response to the coronavirus pandemic has taken advantage of digital technologies and big data to allow for precise live monitoring of the situation and make information available to health sector professionals and the general population.
 
Integrating data from the National Health Administration and Customs was one of the first moves of the Taiwanese government to strictly monitor the risk of imported Covid-19 cases. This allowed the health administration to access the 14-day travel history of any individual, and later their 30-day travel history. Taiwan’s Executive Yuan allowed all hospitals, clinics and pharmacies to access the patients’ travel history. To enhance the monitoring of incoming travelers to the island, the Taiwanese government created a mandatory health declaration for all inbound passengers. Providing inaccurate information can lead to a fine up to US$ 5000. This declaration provided a basis for classifying travelers into risk categories and implement Taiwan’s quarantine policy. 
 
The stored data of the National Health Administration was also used to identify 113 individuals who had consulted for severe respiratory syndromes in January and February and tested negative for influenza. They were all proactively re-tested for Covid-19, and one tested positive. This sophistication in the use of medical data and digital tools relies on wide data collection practices. All health professionals on the frontline have been trained to ask patients about their travel history, occupation, contact history and “cluster” – the group activities in which they have recently been involved – when consultations reveal respiratory syndromes.
 

On the production side, Taiwan enacted a temporary export ban on surgical and N95 masks; and ordered on February 11 the installation of 60 production lines to boost mask production from 4 million to 10 million units per day. The military mobilized 1 800 reserve troops to join the production lines. Many media reports praise the companies for 24 hours no-interruption production – in Tainan city, the company Ge’ande increased its daily production from 200 000 to 600 000 units per day by adding 39 workers from the military to its staff of 10 employees. Wearing face masks is important as a self-protection measure, but there is also a strong encouragement by the government, and on April 4, the Taipei city government announces that passengers entering subway stations without a face mask will receive a verbal warning followed by a fine between NT$3,000 (US$100) and NT$15,000 (US$500).
 
Taiwan started implementing a rationing system in early February, making masks only available at pharmacies, medical stores and in the ubiquitous network of convenience stores. In practice, the distribution system is linked to National Health Insurance cards. Each citizen is allowed to buy three masks on designated days based on the last digit of their social security number. Their purchase history is stored in the system for each selling unit to check. To ensure the effective allocation of masks to selling points, the national distribution of masks is carried out through the mobilization of the state-owned Chunghwa post company. 1,4 million masks have been allocated each day to the medical workforce in the early stages of the outbreak. This distribution system was complemented by a government-managed ordering website that went online on March 12.
 
Taiwan’s national mask economy is digitalized so that the population has full visibility of the availability of masks. An application integrating Google Maps shows on each connected device the stocks of masks in all designated selling locations. Access to that information is also possible through Line (the main chat app in Japan and Taiwan) and other applications. This effort required the setting up of 20 servers by the National Health Insurance Administration (making it 32 in total) to ensure the cloud capacity to handle the surplus traffic.

But the threat of sanctions also matters enormously. In the space of two weeks in early March, Taipei municipal government sanctioned 70 individuals for violating quarantine regulations, with dissuasive fines up to US$ 33,241 (TW$1 million). And the “Special Act on Covid-19 Prevention, Relief and Restoration” (嚴重特殊傳染性肺炎防治及紓困振興特別條例) allows the government to film and photograph people who break quarantine and publish their personal information – a naming and shaming approach. However, sanctions is not the only aspect of the quarantine policy. The Taiwanese government has promulgated legislation to compensate quarantined individuals when they have to take care of children under 12 – the compensation is of NT$1,000 (US$33.35) per day.

In sum, strict quarantine of risky individuals, rather than confinement or testing, is the cornerstone of Taiwan’s crisis management. This has allowed the Taiwanese government to focus testing on individuals showing Covid-19 symptoms. Backed by precise data access and prohibitive sanctions, complemented by travel bans and proactive screening, the strict approach to quarantine has so far allowed Taiwan to contain the contagion. 

Taiwanese hospitals have thus been able to anticipate and focus on best managing patient flows, in order to guarantee the isolation of Covid-19 infected patients in the event of a sudden case increase. The country has a limited number of beds in isolation negative pressure wards (943) but government officials have announced that the reconfiguration of wards and use of single-bed rooms was possible to build isolation capacity if necessary. The Executive Branch has also adopted a special budget to address the cost of crisis management, including the longer term cost on economic activity, when enacting Special Act on Covid-19 Prevention, Relief and Restoration (嚴重特殊傳染性肺炎防治及紓困振興特別條例), which includes a stimulus package of maximum NT$60 billion (US$1.97 billion). In early April, the stimulus package is announced to include measures of a maximum NT$1.05 trillion ($34.72 billion).

All in all, despite a population of 23,78 million, Taiwan has managed to focus on individual cases and their entourage and to craft a policy response based on precise situation awareness to preempt contagion, relying on digital technologies to monitor, inform and impose sanctions against socially dangerous behavior.